Northwell Health Laboratories: The 10-Year Outcomes After Deciding to Keep the Lab

Abstract

Context.— Northwell Health Laboratories were established in 1997, serving the Northwell Health system. In 2008, the health system considered minority entry into a joint venture with a commercial laboratory. Based on arguments made by Northwell laboratory leadership, the decision was made to retain full ownership of the laboratory. Objective.— To evaluate the 10-year outcomes of the 2008 decision and assess the value of a fully integrated laboratory service line for a regional health network. Design.— Ten-year outcomes were analyzed including financial, volume, and value-based activities. Results.— First, a fully integrated laboratory service line was created, with unified medical and managerial leadership. Second, Core Laboratory volumes and revenues grew at annualized rates of 4.5% and 16.0%, respectively. Third, hospital-based laboratory costs were held either constant, or grew in accordance with strategic clinical programs. Fourth, laboratory services were able to provide leadership in innovative system clinical programming and value-based payment programs. Fifth, the laboratories became a regional asset, forming a joint venture affiliation with New York City Health + Hospitals, and supporting distressed hospitals in Brooklyn, New York. Lastly, Northwell Health Laboratories have become a reputational asset through leadership in 2 consortia: The Compass Group and Project Santa Fe. Conclusions.— The 10-year outcomes have exceeded projections made in 2008, validating the decision to retain the laboratories as a wholly owned system asset. The laboratories are now well positioned for leading innovation in patient care and for helping to drive a favorable posture for the health system under new payment models for health care.

Generating Discretionary Income in an Academic Department of Pathology

“…The importance of discretionary funds cannot be overemphasized in this era of increasing pressure on departmental budgets. Options for generating such funds have been published and include partnering with commercial laboratories, 6 consolidation of laboratories that coexist in a health care system, 7 , 8 marketing direct-to-consumer testing, 9 redirection of health system dollars to departments, 10 , 11 philanthropy for education and research programs, 12 and institutional support for education and research. 13 Important to all of these ventures is appreciation of the value proposition of pathologists, whose services can drive better outcomes for patients, health care personnel, and financial stakeholders alike.…”

The Value Proposition for Pathologists: A Population Health Approach

“…As laboratory test reimbursement likewise shrinks, the hospital or academic laboratory itself is at risk, which implies that Part A payments also will be at risk. 10,106 The challenge for pathologists will be not only to add value but to also quantitatively prove to payers and health systems of the value we have added and of their return on investment for supporting pathologists in these new activities.…”

COVID-19 Pandemic Spurs Evolution of an Academic Pathology Department and Laboratory

“…An associate vice president for laboratory services position has been posted, and discussions are in progress about pathology and laboratory forming the first true service line in the health system, as has been accomplished at other centers. 2 , 3 In addition, our productive working relationship and recognition of the effort of the pathology faculty members have also fueled discussions toward an improved hospital contract for the pathology department.…”